Goal: 365 days of posts

Menu

Nutrition Notes

Documentary on epigenetics, my favourite class last semester. This shows research from several different scientists into how your lifestyle affects your children and grandchildren and great-grandchildren… They tried to make it sound exciting and groundbreaking and creepy and revolutionary, but I don’t quite see how it can be. The discovery of the mechanism-yes, maybe. Maybe science has been so near-sighted that breaking the genetic code was supposed to be the be-all and end-all (can you say hubris?!). But the concept that your children are affected by what you do to the third and fourth generation? So old it’s Biblical.

A couple of points to take home:

– Eat to USDA standards and avoid stressful situations if you’re pregnant, may become pregnant, or are a teenaged male. Stop laughing.

– Get nutrigenetic testing asap-the future will be way cool.

– Pay attention to the diseases your direct ancestors have and take preventative steps now.

One of the most excruciating things we have to do as nutrition majors is also one of my favourites: diet practice.

Who likes being told what to eat? Not I, said the Kate. (Which begs the question, why would the Kate want to be a dietitian?) But diet practice forces the Kate to learn far more about the applications of potential diet advice than the average assignment, so it feels like a break from school (yay!).

We don’t get enough of it, in my opinion-but nutrition majors are taught empathy and a few principles of education along with all the technical details of food and metabolism. One of those empathy assignments is dieting for critical illnesses and writing about our experiences. Last semester was the worst-two consecutive days of low protein and then 3 of low potassium for kidney failure patients. Potassium wasn’t so terrible, but for the protein diet we had to meet or exceed a certain calorie level while never going over a truly minuscule protein limit. That low protein diet made me angry and annoyed and cranky and generally nasty for 3-4 days-before, during, and after. It was horrible trying to plan it, it was horrible to follow, and it made me feel horrible health-wise. In case you were wondering, Swedish Fish do not mix well with Coca-Cola-and that’s basically all you can eat that’s protein-free.

Aside: If you are ever diagnosed with one of the early stages of chronic kidney disease, do everything they tell you ASAP. There’s usually hope that you can stop or slow the progression of the disease if you make a few relatively simple lifestyle changes. Good dietitians can help you figure out a diet you can live with while compromising on your favourite foods-and trust me, what look like little frustrations right now will be much, much better than an extremely low protein diet or dialysis.

This semester is looking better than last year. Our first assignment in this vein is a 5-day diabetic diet, where we have to aim for certain carbohydrate levels at each meal. I was really surprised at how much I had to eat to make those levels. As an example, a woman who’s 5’4″ and fairly active needs about 1800 calories. Half of those calories should come from carbohydrates (sugar and fiber) and since 1 gram of carb = about 4 calories, that comes out to 225 grams. If you think of it in terms of specific foods, that’s

– 15 slices of bread, or

– 5 and a half cokes, or

– 40 Girl Scout Thin Mints, or

– 8 cups of ice cream, or

– 9 bananas, or

– 6 slices of Domino’s pepperoni pizza

I’d always thought a diabetic diet would be really restrictive-and it is. But it’s more about watching when you eat things and staying on top of portion sizes than giving up all tasty food. To get good blood sugar control, sugary foods should be distributed pretty evenly throughout the day-say three meals and a couple snacks. Confession: I’ve resorted to both butterbeer and coke already this week to make my carb quotas.

Those Korean dishes I did manage to try on my own had turned out to be delicious-so on my birthday, I wanted Korean food. My awesome parents decided to indulge my every wish (months of begging pays off!) and we went to a Korean restaurant with a couple of friends. We decided to go family style so we could all have a chance to try everything. Wealth and riches! Reviews below-and sorry there are no pictures. Maybe when I’m done with Goal #39 pictures will be possible. For now, my webcam tends not to travel to restaurants 😉

– Fried dumplings: This was an appetizer, and it had already disappeared by the time the second half of the family made it to the restaurant. Dumplings are my absolute favourite Asian food ever. So even though this isn’t the most “Korean” offering on the menu, I will be back just for this.

– Pork belly: I’d been waiting for a large group to try this with. The sweet ajumma who has been helping with my Korean pronunciation for months grilled it at the table and cut it to pieces with giant scissors. There were two types of sauce with it, but I never found out what they were called. The sauces were good. The pork belly itself was a lot more chewy than normal American fare, and something on the order of 80% fat. Like inch-thick non-cured bacon without all the salt and chemicals that make it taste good. Probably won’t go with this again unless someone else orders it.

– Kimchi pancake: Kimchi baked with onion and flour and probably some other tasty veggies-delicious. It was a little hard to eat with the chopsticks, but savoury pancakes are such a brilliant idea. Have to learn how to make it now that Mom has taken to buying me kimchi from the grocery store but making faces whenever I open the jar-maybe it’ll be less fragrant in pancake form 🙂

– Kimchi soup: Tofu and kimchi in a flavourful broth, served in a very hot stone bowl. I need to work on my wimp factor. This stuff was spicy-but really good.

– Seafood/Tofu soup: I don’t like seafood, so not being able to tell what was in this was a good thing. Again, too spicy for my wimpy taste buds but otherwise great.

– Banchan: Mmmmmmmmm, pickled radishes! Kimchi! Glazed potatoes! I think all 7 people at the table found something they liked.

– Beef and pork bulgogi: Basically what Americans think of when we think of teriyaki or stir fry. Hogged by the little brothers and pronounced good. As they had been teasing me for months by groaning whenever I brought up the subject of Korean food, this was a pleasant surprise. Must go back and actually try these.

– Sweet potato cake: A beautifully packaged and decorated gift from Korean friend. She got it from Tous le Jours (yes, we do have one in my city and yes, I will definitely be going back). Pastry chefs are amazing. I can’t imagine making edible adornments like the rosettes and crumb dust on this specimen. Cakes (and overly sweet pancakes, cinnamon rolls, donuts, white breads…) have declared war on almost every organ in my body so I usually observe the ceasefire and avoid them, but I ate this and liked it quite a bit before things started to hurt. It was sweeter and yellower than I expected (we grow different varieties of sweet potato-another thing I didn’t know).

I had an… interesting week. Dear readers, you may not know of my dread of shrimp and all things crustacean. Trust me when I say it’s more potent than my fear of octopus arms and almost as debilitating as needles. This may change if I am ever confronted with a live octopus (the arms chopped up in stew aren’t so bad), but after a childhood shelling trauma the little pink and white and green monsters have been at the very top of my list of things to avoid. This week a dear, kind older relative who is hyper-aware of this dilemma decided that if I was going to Asia I needed to get used to seafood and gave me a whole fried shrimp. On the understanding that it was to be eaten, right away.

I have been shuddering for days. It wasn’t bad-tasting and I wouldn’t have cared had I not known what it was, but… still freaking out. There’s something about it being a whole animal that makes it so much harder to take. The eyes, the eyes! At least with normal grocery store meats you can suspend imagination. This is quite hypocritical as I am really in love with the idea of transparency and knowing all about where your food came from, but seriously-America wouldn’t be nearly this fat if McDonald’s kept their meat cows at the Golden Arches. Or is that just me?

Then there was this morning. It was the request of a kind elderly teacher that I be vaccinated against missing her class (ooh, a pattern! Yes, this is a dangerous weakness). Shots are bad at the best of times, but this had to be done before classes in the middle of the week and listed possible side effects included soreness, hoarseness, aches, fever, coughs, headache, itching, fatigue… What, I ask you, is the point of getting a shot to prevent something that the shot can just give you anyway?*

So here I sit, nursing my swollen arm and cold tea, and cry tears of self-pity to the tune of the smallest violin in the universe. You know the one. My mum used to play it for me sometimes when I wanted to stay home from school. It goes like this:

*That was a rhetorical question. Medical major here. Medical majors can have nervous breakdowns too.

I think I’ve mentioned university classes at some point. We started back up again this week, and this is the result:

I do love my nutrition degree in the main, but there are some classes that are a little bit hard to get through. About 1/3 of the way into this morning’s 8 AM I noticed an absolutely adorable little monkey in the purse of the girl next to me. Instant inspiration. This notecard is the story of The Monkey and His Girl. Written in script so tiny that I will never be able to decipher it and in the shape of some sort of fantastic flower that didn’t quite get finished plus a full-on double bird shape that now that I think about it looks more like a W than anything else. But there you go.

Oh, that story! He fell out of the purse and had an adventure with some apparently friendly rats, but she got sick and he knew he had to come back. Then the rats became a little too friendly and tried to kidnap him. It was a tricky escape. And lest you think that I paid no attention whatsoever to the lecture, I now understand that my teacher thinks the “Two Factor Theory of Herzberg” *might* need a little revision (I don’t really think it matters if you call them hygiene factors or motivators as long as you know how to use them) and “There is a job for you in the food service industry!”

All right, at the very great risk of looking excessively lazy, here’s what I did while offline. Pretty much all I did in the way of homework. Pretty painful. Wrote it over a single very long night and into the next day, missing half of the next day’s classes but attending, stupidly enough, PE because that’s where attendance counts most and nearly falling a whole bunch of times trying and failing to learn a new roundhouse kick… Oh, let’s just get it over with. Here you go.

Amy Brown defines probiotics in her textbook Understanding Food: Principles and Preparation as “live microbial food ingredients (i.e., bacteria) that have a beneficial effect on human health” (Brown 2011, G-6) In middle-class America, the idea of voluntarily consuming bacteria is counter-intuitive. We spend a great deal of time and money trying to find new ways to kill bacteria in our food supplies before they reach us. We take antibiotics for serious diseases. We pasteurize cheese and beer; killing most of the microorganisms that make these products to reduce our chances of ingesting toxic bacteria. We are even trained to fuss at children for eating off our “germy” home floors. We refuse to eat any but the freshest restaurant produce. Yet we are also quite prone to fads.

Researchers and salesmen have proposed many reasons for us to indulge in the recurring fad of probiotics. The most common claim is that products alleviate undesirable gastrointestinal symptoms such as bloating, irregularity, gas, stomach discomfort, and diarrhea (Schardt 2006, 7-9). Yogurt in particular has been used in diarrhea patients for centuries (Brown 2011, 222). Preliminary research seems to show that some probiotics can shorten the duration of colds and help balance a digestive system upset by hospital- or antibiotic-induced infections (Schardt 2006, 8-9 under Stonyfield Farm Yogurt and Florastor). Also, probiotics are classified as food and thus seem to have fewer risks and gentler regulations than medicines like antibiotics.

Consuming live bacteria is certainly not without risk, though. Some challenges to the probiotic industry include reducing risk of gastrointestinal upset possibly caused by the bacteria themselves (Schardt 2006, 8 under DanActive Drink) and preventing contamination by wild bacteria and early spoilage. Various strains of bacteria may cause allergic reactions. Testing is difficult and expensive and relies on volunteers, which introduces a high probability of bias. As the term “probiotic” is not tightly regulated, confusion can easily result as to what exactly a product contains. Some manufacturers make claims bordering on panacea for poorly tested products (Schardt 2006, 9 under Culturelle). All of this can be dangerous to the unwary consumer.

Another consideration to remember is that researchers are just beginning to look into what causes a change in human gut microflora. A strong contender for the post is diet (Wu et al. 2011, 1-5); others might include genetics and cultural or geographical environment. One study connected all three in a study of how the gut may influence obesity and vice versa (Flier and Mekalanos 2009, 1-3). Probiotics introduce new bacteria into the gut (though not in large amounts) and thus could theoretically have a direct influence on the composition of the gut microbiome. Yet long-term studies should be performed, especially on the effect of multiplying “good” bacteria to crowd out and place a barrier between the body’s immune system and “bad” bacteria. There is so much bacteria in the human gut that it will take researchers some time to find out whether some bacteria are more important than others in disease prevention and control (Wu et al. 2011, 3).

Probiotics have a mixed reliability rate; sometimes there is research to support health claims blazoned on packaging, but sometimes the evidence is elusive. Before deciding to incorporate any product containing probiotics into their diet, consumers ought to check any scientific studies performed on the specific strain of bacteria for success rate as proof of packaging claims. For example, in an article summarizing this information for several products on the market in 2006, some probiotics were in a far more advanced stage of testing than others: the bacteria in Kashi Vive Cereal had never even been tested for health benefits, while the yeast in Florastor reduced incidence of diarrhea after a course of antibiotics in several large, well-done studies (Schardt 2006, 8-9). For further contrast, the DanActive Drink was only studied in a small population of elderly men and women in Italy, and a fourth of the study’s participants suffered from such intense gastrointestinal problems while using the drink that their daily dose was halved (Schardt 2006, 8). Thus, unless a consumer takes the time to research any probiotic health claims himself, he could end up paying top dollar for a product that is untested and may even be harmful.

According to its website, the National Yogurt Association’s “Live Active Culture Seal” is an official seal voluntarily placed on yogurt products that contain a certain quota of live bacteria. Because this seal is voluntary and counts both starter bacteria used to ferment the yogurt and added probiotics, naturally high levels of starter bacteria can make the designation somewhat misleading (Douglas 2008, 514).

According to the Brown textbook, prebiotics are “Nondigestible food ingredients…that support the growth of probiotics” (Brown 2011, G-7). Mostly, prebiotics are fibers that pass through the stomach undigested and become food for gut bacteria, which can react to provide mutual benefit or to attack their host. Prebiotics thus may also influence the bacterial population of the human gut.

Considering that research into the benefits of probiotics is inconclusive and I am generally healthy and broke, I would not change my own diet to incorporate this new food trend. Nor (in the logical tradition of “if it ain’t broke don’t fix it”) would I recommend specialized probiotics to other healthy friends. According to a microbiologist who wrote a book on the subject, the only reasons for a healthy person to take probiotics are if he is about to take antibiotics, go to the hospital, or travel outside of the country (Schardt 2006, 7). A case might be made for their use in an ill person who is suffering from a specific condition that a specific strain of bacteria is scientifically proven to alleviate. However, specialized probiotics are too new, expensive and unproven to recommend to the average person. Yogurt would be a safer choice for anyone wishing to follow the newest diet trends.

I’ve never thought of the gut as a “microbiome.” But according to one of the newest nutrition trends, a change in what we eat influences what kinds of bacteria grow in our digestive system. Since we have a symbiotic relationship with those bacteria (the reasoning goes), changing the types of colonies we encourage and discourage might change just about everything about how we feel and which diseases we get. In a study published last month (full reference in previous post, short: Linking Long-Term Dietary Patterns with Gut Microbial Enterotypes, Wu et al) researchers found an association between diets focused on vegetables or meats and different taxa of bacteria. Though these associations aren’t strong enough to control or even explain every part of our gut bacterial composition, they may play a role in why we high-animal protein/fat Westerners get different diseases than people who eat more carbs and less meat. Pretty neat, huh? The human body is such an intricate mystery.

Because food is such a tradition in my own religion, I feel I must digress here and add in a bit from my ‘other’ education: “Because the Gospels describe the Last Supper as a Passover meal, we tend to forget that it was also a meal. Eating and the etiquette of the table were deeply significant in ordinary Jewish life, and textured with religious meaning. Among Jews in Jesus’ day, who you ate with was as important as what you ate and how you ate. Since eating was an act of fellowship and acceptance, to eat with sinners was to accept them as friends and companions (Mk 2:15-16).” (~Leonard J. Vander Zee, Christ, Baptism, and the Lord’s Supper) Theologically, Jesus is the bread of life. In the special meal we at my church call The Lord’s Supper, we invite all who have professed belief in Christ and been baptized to eat with us, no matter what sin we’re each struggling with. That’s because in eating this bread and wine, we become a part of a family that spans the world and the centuries. Its purpose is not to discipline, but to unite. Maybe that’s what attracted me to the study of nutrition.

The unfortunate truth is that anyone wishing to be a vegetarian has a lot of dietary work cut out for him or her. It’s easier to understand one component to why this is so if you know a little basic biochemistry, thus:

Almost every single process in a human cell involves proteins. These proteins are mostly manufactured inside the cell itself from building blocks called polypeptides, which are in turn made up of long chains of amino acids. These chains are made to order according to blueprints in every single cell’s DNA. Which proteins are made in cells helps determine your hair colour, your eye colour, your tendency to add fat around your middle before your hips, just about every unique physical characteristic about you.

Most organisms concentrate amino acids around their young, storing them up so that their progeny have enough protein to survive the difficult growing process. That’s why eggs, milk, nuts, seeds, beans, and grains are so high in protein. (Meat is a good protein source because animals also store protein in their muscle.) Leaving out animal products for a moment, what’s wrong with eating a diet composed entirely of nuts? Ok, ignoring scurvy, you’d also be limiting the amount of amino acids you can absorb from those nuts. Why? Because we make certain essential amino acids out of other essential amino acids, and nuts are deficient in two of those key protein components (lysine and isoleucine, but you probably don’t have to know that on your next test). Fortunately for vegans everywhere, legumes (beans) are not limiting in either of the amino acids that make nuts a problem food-but are deficient in two others (tryptophan and methionine), which can be provided by nuts or grains (which are limited in lysine, isoleucine, and threonine). Thus, if you eat beans and rice, you’ve got a complete protein source.

What effect could this have on vegetarians? Meat provides a complete protein source without any supplementation. It also provides a good amount of extra calories from fat and sometimes higher risks of foodborne illness (bacteria love meat precisely because it’s so protein-rich). But if a vegetarian wants a high-quality food source, they must combine their protein sources and eat them at generally the same time to get the same benefits Calvin the Carnivore gets from his slab of hamburger. (I think it was within the same day, but will have to find evidence and document for you.)

To all you brave vegetarians and especially vegans out there, I salute you. It takes a lot of effort and planning to eat like you do and stay healthy.